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All Journal Buletin Farmatera Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Journal of Society Medicine (JSOCMED) Jurnal Penyakit Dalam Indonesia Jurnal Profesi Guru Indonesia
Safri, Zainal
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Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Mathematics Medicine & Pharmacology Neuroscience Public Health Other

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Infark Ventrikel Kanan dengan Blok Atrioventrikular: Laporan Kasus dengan Tinjauan Pustaka Dalimunthe, Naomi Niari; Hasan, Refli; Ahmad, Herwindo; Isnanta, Rahmad; Realsyah, T; Safri, Zainal
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Inferior myocardial infarction is frequently accompanied by right ventricular infarction. This report presents two cases of right ventricular infarction accompanied by hemodynamic disorder and atrioventricular block complications. These patients were diagnosed with right ventricular infarction based on history, clinical presentations, and electrocardiography findings. The management approach for these patients involved optimizing volume and fluid status, using temporary pacemakers, and urgent percutaneous coronary intervention. This report highlights the need to promptly identify right ventricular involvement in inferior myocardial infarction, as the treatment strategies for right ventricular infarction are different from left ventricular infarction.
The Relationship Between Serum Apolipoprotein B Levels and Severity of Coronary Lesions Using The Syntax Score in Non-St Segment Elevation Acute Myocardial Infarction Patients at Haji Adam Malik General Hospital Medan Kesumawardani, Enggar Sari; Safri, Zainal; Hasan, Harris; Hasan, Refli; Andra, Cut Aryfa; Ardini, Tengku Winda
Journal of Society Medicine Vol. 2 No. 4 (2023): April
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i4.32

Abstract

Introduction: Acute coronary syndrome mainly occurs as a result of plaque rupture of atherosclerosis. Apolipoprotein B (apoB) is a large glycoprotein, playing a role in lipoprotein metabolism and human lipid transport reflecting the number of circulating atherogenic particles. The purpose of this study was to assess the relationship of serum apoB levels with coronary lesion severity. Method: This is a cross-sectional study involving patients who was diagnosed with Non-ST Elevation Myocardial Infarction (NSTEMI) who underwent coronary angiography in November 2021 to July 2022. The NSTEMI criteria follow the Universal Definition of Myocardial Infarction and coronary severity is assessed using a SYNTAX score. Bivariate analysis was conducted looking for the relationship between apoB with SYNTAX scores with p<0.05 considered statistically significant. Results: The subjects of the study is 70 people, dominated by male 50 patients (71.4%). The median age of the subjects was 56 (38-77) years. Median levels of apoB was 107 (32-150) mg/dL. The average SYNTAX score was 25.66 ± 10.83. Using the Pearson correlation test, it was shown that there is a significant correlation between apoB and coronary lesion severity obtained r=0.442 (p<0.001). Conclusion: There is a significant correlation between apoB and coronary lesion severity using SYNTAX scores in NSTEMI patients.
Interleukin-6 Reduction as a Predictor of Functional Capacity Improvement after Phase II Cardiac Rehabilitation Programme in Coronary Artery Bypass Surgery Patients Ferhat E.S, Muhammad; Safri, Zainal; Sarastri, Yuke
Journal of Society Medicine Vol. 3 No. 2 (2024): February
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i2.126

Abstract

Introduction: Improved functional capacity is a good prognostic value in patients after CABG. Phase II cardiac rehabilitation provides beneficial effects on physical function, cardiopulmonary function, inflammatory response, autonomic function, and improves functional capacity, and there is a significant decrease in Interleukin-6 values in patients after CABG. Several studies have selected Interleukin 6 as an inflammatory cytokine that can be used to assess the beneficial effects of cardiac rehabilitation in coronary heart disease conditions. The aim of the study was to determine the relationship of Interleukin-6 value as a predictor of functional capacity improvement after phase II cardiac rehabilitation in patients undergoing CABG. Method: This study was analytic observational study conducted retrospectively on 31 CABG patients who underwent phase II cardiac rehabilitation. Data collection on functional capacity, Interleukin-6 examination before and after phase II cardiac rehabilitation. Data were analyzed univariately and bivariately to assess the relationship between Interleukin-6 and functional capacity. Multivariate analysis will then be performed using linear regression. The relationship test will be performed with Pearson correlation test. Statistical data analysis using SPSS software, p value <0.05 is statistically significant. Results: There were 29 samples. The results of the cardiac exercise test showed an increase in distance at the end of phase II cardiac rehabilitation compared to the initial examination (457,655 ± 24,346 vs 180,482 ± 13,941). At the end of the examination there was a decrease in the average Interleukin-6 level from 24.412 ± 2.516 to 13.647 ± 1.413. There was a significant relationship between improvement in functional capacity and Interleukin-6 (p=0.032, r=0.40). An increase of 1 MET will decrease Interleukin-6 by 2.238 pg/mL. There was a decrease in mean Interleukin-6 from 24,412±2,516 to 13,647±1,413 at the end of phase II with p value <0.001. Conclusion: Interleukin-6 can be a predictor of improved cardiac functional capacity after phase II cardiac rehabilitation program in patients undergoing CABG.
Relationship between Atherogenic Index of Plasma (AIP) and Mayor Cardiovascular Event (MACE) in Patients with Acute Myocardial Infarction (IMA) with Percutaneous Coronary Intervention (PCI) in Haji Adam Malik Hospital Ramzi, Defriyan; Hasan, Refli; Safri, Zainal
Journal of Society Medicine Vol. 3 No. 5 (2024): May
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i5.139

Abstract

Introduction: Atherogenic index of plasma (AIP) is a new biochemical parameter closely related to lipid metabolism in the body as a risk factor in atherosclerosis and coronary heart disease. This study aimed to determine whether AIP values could be used to predict major cardiovascular events (MACE) in the treatment period of ACS patients undergoing primary percutaneous coronary intervention processes. Methods: This study was an observational analytical study with retrospective data collection method. Patients who experienced ACS  at RSUP Haji Adam Malik Medan and undergo IKP starting from April 2023 will be collected. Basic characteristic data including laboratory parameters and AIP values as well as MACE events were be collected. Data analysis were carried out whether there are differences in AIP values in MACE and Non-MACE patients, and predictive ability will be assessed through ROC/AUC curve analysis, and sensitivity and specificity values will also be obtained. Results: A total of 69 samples were obtained. A total of 25 patients (36.2%) experienced MACE. The most prevalent MACE in this study was death from all causes as many as 17 patients (24.6%). AIP value can be used as a predictor of MACE events:  Death of All Causes (Cut Off value: 0.505; AUC: 0.673; P = 0.033; 95% CI 0.537 – 0.809; Sensitivity 64.7%; Specificity 59.6%), Acute Heart Failure (Cut Off value: 0.502; AUC: 0.695; P = 0.029; 95% CI 0.551 – 0.839; Sensitivity 69.2%; Specificity 60.7%), and Malignant Arrhythmia (Cut Off value: 0.582; AUC: 0.758; P = 0.026; 95% CI 0.578 – 0.938; Sensitivity 71.4%; Specificity 75.8%). Conclusion: The AIP index can be a good predictor of the incidence of MACE in ACS patients undergoing primary percutaneous coronary intervention.
Statins' Protective Effect For The Prevention Of Atrial Fibrillation Incidence After Coronary Artery Bypass Surgery Putri, Sheila Dhiene; Safri, Zainal
Buletin Farmatera Vol 7, No 2 (2022)
Publisher : Universitas Muhammadiyah Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30596/bf.v7i2.9736

Abstract

Abstract: Atrial fibrillation (AF) after cardiac surgery is associated with an increased risk of complications, length of stay, and cost of care. Recent studies have demonstrated that statins have pleiotropic effects, including anti-inflammatory effects and preventing atrial fibrillation (AF). The objective of this study was to assess the efficacy of preoperative statin therapy in preventing AF after coronary artery bypass grafting (CABG). 53 patients underwent CABG in our hospital from February to August 2018. Patients were randomized into two groups to examine the effect of statins: those with atorvastatin 20 mg/day during the preoperative period (Atorvastatin group, n = 26) and those with rosuvastatin 10 mg/day (Rosuvastatin group, n = 27). The primary end-point is postoperative AF (POAF), with an overall incidence of postoperative AF of 11.3%. Postoperative AF incidence was insignificantly different between the atorvastatin and rosuvastatin groups (7.7% vs. 14.8%; p = 0,669). Our study indicated that atorvastatin had a similar protective effect to rosuvastatin in terms of post-operative AF prevention.Keywords: statin, post-operative AF
Relationship Between Neutrophil-Lymphocyte Ratio Value And Severity of Mitral Stenosis Due to Rheumatic Heart Disease in Outpatients at H. Adam Malik General Hospital Medan Achmad, Aziz; Safri, Zainal; Haykal, Teuku Bob; Siregar, Abdullah Afif; Akbar, Nizam Zikri; Ardini, Tengku Winda; Andra, Cut Aryfa; Lubis, Anggia Chairuddin
Journal of Society Medicine Vol. 3 No. 12 (2024): December
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v3i12.183

Abstract

Introduction: Mitral stenosis (MS) is a heart valve disease characterized by narrowing of the mitral valve, commonly caused by rheumatic heart disease. Accurate evaluation of MS severity is crucial for management, with echocardiography being the gold standard. The Neutrophil-Lymphocyte Ratio (NLR), reflecting inflammation, may correlate with MS severity. This study aims to assess the relationship between NLR values and MS severity due to rheumatic heart disease. Method: This cross-sectional study was conducted at H. Adam Malik General Hospital Medan from January 2023 until the required sample size was achieved. Patients diagnosed with MS by echocardiography based on the American Society of Echocardiography (ASE) criteria were included. Echocardiographic parameters such as mitral valve area (MVA) and mean pressure gradient (MV mean PG), along with blood NLR values, were analyzed for associations. Statistical significance was set at P < 0.05. Results: Significant differences in NLR values were observed between mild-to-moderate MS (1.93; 0.82–10.64) and severe MS (3.56; 1.81–13.08) (P = 0.0001, Mann-Whitney test). An NLR threshold of 2.91 predicted severe MS with 82% sensitivity and 81.8% specificity (P = 0.0001; AUC 0.856; 95% CI 0.772–0.940). Conclusion: NLR strongly correlates with MS severity and serves as a reliable predictor for severe MS in patients with rheumatic heart disease. NLR offers a simple, cost-effective tool for assessing MS severity, complementing echocardiography in clinical practice.
Implementation of Contextual Teaching and Learning Model in Nature-Based Learning to Improve Morals and Concern for the School Environment at SMP S Alam Leuser Safri, Zainal; Hasanah, Siti; Mahmudah; Soraya, Fitri; Siregar, Tuti Sriwahyuni
Jurnal Profesi Guru Indonesia Vol. 1 No. 4 (2024): DECEMBER 2024
Publisher : MANDAILING GLOBAL EDUKASIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62945/jpgi.v1i4.636

Abstract

This classroom action research examines the implementation of the Contextual Teaching and Learning (CTL) model in nature-based learning to enhance students' morals and environmental awareness at SMP S Alam Leuser. The study aims to determine how CTL strategies, which emphasize meaningful and experiential learning, can foster students’ ethical values and ecological responsibility. Conducted in two cycles, this research follows the Kemmis and McTaggart action research model, consisting of planning, action, observation, and reflection. Data were collected through observations, student reflections, teacher journals, and interviews. The findings indicate that integrating CTL with nature-based learning significantly improves students’ moral values, such as honesty, responsibility, and cooperation. Furthermore, students demonstrate increased environmental awareness through active participation in sustainable practices, including waste management, tree planting, and water conservation efforts. Each cycle of the research reveals progressive improvement in student engagement and behavioral changes, emphasizing the role of contextual learning in character building. The study highlights the importance of teacher facilitation in connecting learning materials to real-life environmental issues, making the learning process more relevant and impactful. The results suggest that CTL-based nature learning is an effective pedagogical approach for developing both cognitive and affective competencies in students. This study recommends further exploration of CTL implementation in various educational settings to assess its broader impact on student character development and environmental consciousness.
Incidence of Bleeding Complications in Acute ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention Ferhat, Muhammad; Lubis, Anggia Chairuddin; Safri, Zainal; Mukhtar, Zulfikri; Hasan, Harris; Haykal, Teuku Bob; Siregar, Yasmine Fitrina; Andra, Cut Aryfa
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 7 No. 3 (2025): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v7i3.21143

Abstract

Background: This study aims to comprehensively describe the incidence, types, and associated risk factors of bleeding complications in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI), addressing a critical gap in the literature given the global burden of cardiovascular disease and the inherent bleeding risks of contemporary antithrombotic therapies. Methode: This retrospective cross-sectional study will investigate the incidence and types of bleeding complications, along with associated risk factors, in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) at Adam Malik Hospital Medan, analyzing data from May 2022 to December 2024 through ethical review and statistical analysis using SPSS version 23. Result: Of 245 STEMI patients undergoing primary PCI, 42.9% experienced bleeding, predominantly minor (BARC 1 and 2, 94.2% combined), with significant associations observed between bleeding and lower hemoglobin, higher leukocyte and creatinine levels, higher TIMI score, Killip class 3 and 4, diabetes, use of maintenance heparin, and increased mortality (84.6% of all deaths occurred in bleeding patients), while hematuria and puncture site hematoma were the most common bleeding sources. Conclusion: This study found that 42.9% of 245 STEMI patients undergoing primary PCI experienced bleeding complications, predominantly minor (94.2%), with an average age of 55.22 years and a male majority. Keyword: Bleeding complications, Acute Coronary Syndrome (ACS), ST-Elevation Myocardial Infarction (STEMI), Primary Percutaneous Coronary Intervention (PPCI)
Co-Authors Achmad, Aziz Ahmad, Herwindo Akbar, Nizam Zikri Andra, Cut Aryfa Ardini, Tengku Winda Dalimunthe, Naomi Niari Ferhat E.S, Muhammad Ferhat, Muhammad Hasan, Harris Hasan, Refli Kesumawardani, Enggar Sari Lubis, Anggia Chairuddin Mahmudah Mukhtar, Zulfikri Putri, Sheila Dhiene Rahmad Isnanta, Rahmad Ramzi, Defriyan Realsyah, T Sarastri, Yuke Siregar, Abdullah Afif Siregar, Tuti Sriwahyuni Siti Hasanah Soraya, Fitri Teuku Bob Haykal Yasmine Fitrina Siregar